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1.
Hye Jin Joo Gi Hyun Kim Won Joong Jeon Hee Bok Chae Seon Mee Park Sei Jin Youn Jae Woon Choi Rohyun Sung 《World journal of gastroenterology : WJG》2009,15(27):3440-3444
We report a rare case of a 74-year-old man with metachronous gallbladder cancer and bile duct cancer who underwent curative resection twice, with the operations nine years apart. At the age of 65 years, the patient underwent a cholecystectomy and resection of the liver bed for gallbladder cancer. This was a welldifferentiated adenocarcinoma, with negative resection margins (T2NOM0, stage Ⅰ B). Nine years later, during a follow-up examination, abdominal computed tomography and MRCP showed an enhanced 1.7 cm mass in the hilum that extended to the second branch of the right intrahepatic bile duct. We diagnosed this lesion as a perihilar bile duct cancer, Bismuth type Ⅲ a, and performed bile duct excision, right hepatic Iobectomy and Roux-en-Y hepaticojejunostomy. The histological diagnosis was a well-differentiated adenocarcinoma with one regional lymph node metastasis (TINIM0, stage Ⅱ B). Twelve months after the second operation, the patient is well, with no signs of recurrence. This case is compared with 11 other cases of metachronous biliary tract cancer published in the world medical literature. 相似文献
2.
Atsunori Nakao Kenichi Sakagami Masashi Uda Shintaro Mitsuoka 《Journal of gastroenterology》1997,32(1):110-113
A rare case of double cancers of the gallbladder and bile duct associated with anomalous choledo-chopancreatic duct junction (ACPDJ) is reported. The patient was a 61-year-old Japanese woman who with presented right upper quadrant abdominal pain. Liver function tests results were normal. Computed tomography showed a polypoid lesion in the gallbladder, and endoscopic retrograde cholangiopancreatography (ERCP) demonstrated ACPDJ and irregular wall of the inferior bile duct. A diagnosis of double cancers of the gallbladder and bile duct was made and a pancreaticoduodenectomy and liver bed resection was performed. His topathological examination showed papillary adenocarcinoma of the gallbladder and mucosal adenocarcinoma of the bile duct. The patient is in good health 15 months after the operation and shows no signs of recurrence. A review of the literature is presented. 相似文献
3.
Yuji Kaneoka Akihiro Yamaguchi Masatoshi Isogai 《Journal of hepato-biliary-pancreatic sciences》2007,14(2):142-148
Background/Purpose
We aimed to determine whether bile duct cancer (BDC) or gallbladder cancer (GBC) was a better candidate for hepatopancreatoduodenectomy (HPD).Methods
Ten patients with BDC and ten with GBC were treated by HPD with major hepatectomy between 1994 and 2004 and compared, in terms of surgical outcome and survival.Results
In the BDC patients, the International Union Against Cancer (UICC) stage was I in three patients; II in four; III in one; and IV in two; of the GBC patients, one was stage II; four were stage III; and five were stage IV. The reasons for choosing HPD for BDC were: superficial spreading, in three patients; intramural wide invasion, in five; and hepatoduodenal ligament (HDL) invasion, in two; and for GBC, extrahepatic bile duct invasion, in seven; and HDL invasion, in three. The morbidity and mortality rates for BDC and GBC were 40% and 60%, and 0% and 30%, respectively. All three of the GBC patients who died in hospital had undergone a right trisectionectomy with caudate lobectomy. The cumulative 5-year survival rate of the BDC patients was 64%; the 1-year survival rate for the GBC patients was only 20%, and none survived for over 2 years (P < 0.001). Of the patterns of BDC cancer invasion, the superficial-spreading type appeared to have a better prognosis than the others, but the difference was not statistically significant.Conclusions
HPD is indicated for any type of BDC, but HPD did not show any survival benefits in treating patients with GBC with obstructive jaundice.4.
Tsutomu Fujii Tetsuya Kaneko Hiroyuki Sugimoto Osamu Okochi Soichiro Inoue Shin Takeda Tetsuro Nagasaka Akimasa Nakao 《Journal of hepato-biliary-pancreatic sciences》2004,11(4):280-285
We report a rare case of metachronous double cancer of the biliary tract. At age 59 years, a man had undergone a cholecystectomy and resection of the liver bed for gallbladder cancer pathologically diagnosed as papillary adenocarcinoma, in 1997. Four years later, he was admitted to our hospital with jaundice. At first, we suspected lymph node metastasis of the gallbladder cancer along the common bile duct. But abdominal computed tomography demonstrated circular wall thickness of the common bile duct, so primary bile duct cancer was strongly suspected. Thus, extended right hepatectomy and pancreaticoduodenectomy were performed after right portal vein embolization. The pathological diagnosis of the resected specimen was well-differentiated tubular adenocarcinoma, and this case was clarified to be metachronous double cancer. A review of the literature regarding double cancer of the biliary tract is presented following this case report. We showed that half of 30 cases of double cancer of the biliary tract were not associated with pancreaticobiliary maljunction, including all 6 metachronous cases. 相似文献
5.
Sato K Maekawa T Yabuki K Tamasaki Y Maekawa H Kudo K Sengoku H Kawa I Wada R Matsumoto M 《Journal of gastroenterology》2003,38(1):97-100
We report a 74-year-old man with triple synchronous cancers occurring in the gallbladder, common bile duct, and pancreas.
The patient had consulted a nearby physician because of epigastralgia and icterus. On September 30, 1997, the patient was
admitted to our department for further evaluation and treatment. Abdominal computed tomography (CT) showed dilatation of the
common bile duct, cystic duct, and intrahepatic bile duct, and swelling of the gallbladder. On CT, the wall of the distal
common bile duct was thick and a low-density mass was detected on the left side. Cholangiography, performed via percutaneous
transhepatic cholangiodrainage (PTCD), revealed stenosis of the distal common bile duct. Endoscopic retrograde pancreatography
(ERP) showed marked dilatation of the main pancreatic duct. On October 17, 1997, pancreatoduodenectomy was performed under
the diagnosis of carcinoma of common bile duct and pancreas. Histopathological examination revealed poorly differentiated
tubular adenocarcinoma of the common bile duct, well-differentiated tubular adenocarcinoma of the gallbladder, and mucinous
cystadenocarcinoma of the pancreas. These three tumors were histopathologically different. Moreover, p53-positive nuclei were
recognized only in the pancreas tumor. These findings suggested that the oncogenic mechanisms of multiple synchronous cancers
were not the result of only abnormal DNA reparative mechanisms.
Received: March 15, 2001 / Accepted: December 14, 2001
Reprint requests to: K. Sato 相似文献
6.
Tatsuaki Sumiyoshi Yasuo Shima Akihito Kozuki 《World journal of gastroenterology : WJG》2012,18(41):5982-5985
We report an extremely rare case of synchronous double cancers of the common bile duct without pancreaticobiliary maljunction. Only two similar cases have been reported in the English literature. Endoscopic re-trograde cholangiopancreatography showed a tuberous filling defect in the middle and superior parts of the common bile duct, and mild stenosis in the inferior duct. Computed tomography (CT) showed a well enhanced mass in the middle and superior parts of the common bile duct. A single cancer of the middle and superior bile duct was suspected and extra-hepatic bile duct resection was performed. CT eleven months after surgery revealed enhanced inferior bile duct wall and a slightly enhanced tumor within it. Retrospective review of the CT images taken before first surgery showed enhanced inferior bile duct wall without intrabiliary tumor only on the delayed phase. The inferior bile duct tumor was suspected to have originally co-existed with the middle and superior bile duct tumor. Pancreaticoduodenectomy was performed subsequently. Histopathological examination revealed that the middle and superior bile duct tumor was a moderately differentiated tubular adenocarcinoma while the inferior bile duct tumor was a papillary adenocarcinoma. The two tumors were separated and had different histological findings and growth patterns, further suggesting that they were two primary cancers. 相似文献
7.
Yamaguchi K Shirahane K Nakamura M Su D Konomi H Motoyama K Sugitani A Mizumoto K Tanaka M 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2005,7(2):135-138
Hypothesis. Frozen section diagnosis and permanent diagnosis of bile duct margin predict local recurrence after surgical resection of gallbladder or bile duct carcinoma. Design. Retrospective review. Setting. University, tertiary care. Patients. A total of 20 patients underwent frozen section diagnosis of bile duct margin for resection of gallbladder and bile duct carcinoma. Main outcome. Diagnosis of frozen and permanent section of bile duct margin, and local recurrence. Results. The permanent diagnosis was identical in 15 patients but changed in 5 (from positive to negative in 3 and from negative to positive in 2). The reasons for these changes were overdiagnosis (mucosal lesions in two and mesenchymal components in another) and new recognition of malignant cells on permanent section in the other two. In seven patients with a positive bile duct margin by permanent histology, mucosal spread was evident in two and involvement of the subepithelial layer was present in the other five. No local recurrence occurred in the two patients with epithelial spread and four of the five with subepithelial infiltration. Conclusions. Frozen section and permanent diagnoses of the bile duct margin in gallbladder and bile duct carcinoma may be inconsistent in 25% of patients due to overdiagnosis of frozen section or new recognition of cancer cells by permanent histology. In situ carcinoma does not always produce local recurrence, while cancer cells in the subepithelial layer strongly predict occurrence of local recurrence. 相似文献
8.
Takeshi Sasaki Satoshi Kondo Yoshiyasu Ambo Satoshi Hirano Toshiaki Sichinohe Kichizo Kaga Hiroshi Sugiura Eiji Shimozawa 《Journal of hepato-biliary-pancreatic sciences》2006,13(5):458-462
We report a male patient aged 45 years, who in 1993 had been diagnosed as having middle bile duct cancer and had received a pancreatoduodenectomy. Histopathology showed a nodular tumor with the main lesion in the middle bile duct and superficial spreading in both proximal and distal directions (which was not observed macroscopically), and residual tumor in the epithelium of the cut edge near the liver. The patient underwent follow-up without postoperative adjuvant therapy. In 2002, 9 years after the operation, the patient developed jaundice and was diagnosed with recurrence of bile duct cancer in the anastomotic site, based on cholangiographic results. He underwent resection of the right hepatic and caudate lobes and the anastomotic region of the bile duct and jejunum. Pathological findings showed an invasive tumor in the anastomotic region, with continuous intraepithelial spread in the direction of the bile duct, which suggested that the residual tumor in the epithelium had grown to become an invasive cancer. In this patient, the recurrence required 9 years after resection. This case provides evidence for the clinical course that might be anticipated for a patient with a residual tumor in the epithelium of the bile duct stump and subsequent superficial spreading bile duct cancer. 相似文献
9.
10.
Early bile duct cancer 总被引:3,自引:0,他引:3
11.
12.
Nakayama Toshimichi Saitsu Hideki Shibata Jyunji Hasuda Akira Kinoshita Hisafumi Yasunaga Masafumi 《Journal of hepato-biliary-pancreatic sciences》1995,2(3):229-232
Hilar bile duct resection, by which only the bile duct is resected, was carried out in 31 patients with bile duct carcinoma at the hepatic hilus. However, curative resection was possible in only 4 patients (12.9%). The postoperative 1-, 3-, and 5-year survival rates were 58.1%, 19.4%, and 7.7%, respectively. These results indicate that treatment of this hilar bile duct carcinoma by hilar bile duct resection is of limited value. We believe that this operative procedure should be used only for papillary or nodular carcinoma at the hepatic confluence at relatively early stages of Bismuth's type I or II. 相似文献
13.
Jung-Wook Kim Jae-Young Jang Young Woon Chang Yong Ho Kim 《World journal of gastroenterology : WJG》2015,21(27):8358-8365
AIM: To investigate the incidence and distribution of second primary cancers (SPCs) in early gastric cancer (EGC) patients who underwent endoscopic resection (ER), compared to advanced gastric cancer (AGC) patients who underwent surgery.METHODS: The medical records of 1021 gastric cancer (GC) patients were retrospectively reviewed from January 2006 to December 2010. The characteristics and incidence of SPCs were investigated in those with EGC that underwent curative ER (the EGC group) and those with AGC who underwent curative surgical resection (the AGC group).RESULTS: We ultimately enrolled 184 patients in the EGC group and 229 patients in the AGC group. A total of 38 of the 413 (9.2%) GC patients had SPCs; the rate was identical in both groups. Of these 38 patients, 18 had synchronous and 20 had metachronous cancers. The most common SPC was lung cancer (18.4%), followed by colorectal cancer (13.2%) and esophageal cancer (13.2%). No significant risk factors were identified for the development of SPCs.CONCLUSION: Endoscopists should provide close surveillance and establish follow-up programs to ensure SPC detection in GC patients undergoing curative resection regardless of their clinical characteristics. 相似文献
14.
Fumihide Itokawa Takao Itoi Atsushi Sofuni 《Journal of hepato-biliary-pancreatic sciences》2010,17(5):731-732
We described the usefulness of peroral videocholangioscopy for diagnosis of early bile duct cancer. In addition, we introduce the observation of the lesion using narrow band imaging in combination with a conventional white light imaging. 相似文献
15.
Djuranovic SP Ugljesic MB Mijalkovic NS Korneti VA Kovacevic NV Alempijevic TM Radulovic SV Tomic DV Spuran MM 《World journal of gastroenterology : WJG》2007,13(27):3770-3772
Double common bile duct (DCBD) is a rare congenital anomaly in which two common bile ducts exist. One usually has normal drainage into the papilla duodeni major and the other usually named accessory common bile duct (ACBD) opens in different parts of upper gastrointestinal tract (stomach, duodenum, ductus pancreaticus or septum). This anomaly is of great importance since it is often associated with biliary lithiasis, choledochal cyst, anomalous pancreaticobiliary junction (APBJ) and upper gastrointestinal tract malignancies. We recently recognized a rare case of DCBD associated with APB3 with lithiasis in better developed common bile duct. The opening site of ACBD was in the pancreatic duct. The anomaly was suspected by transabdominal ultrasonography and finally confirmed by endoscopic retrograde cholangiopancreatography (ERCP) followed by endoscopic sphincterotomy and stone extraction. According to the literature, the existence of DCBD with the opening of ACBD in the pancreatic duct is most frequently associated with APB3 and gallbladder carcinoma. In case of DCBD, the opening site of ACBD is of greatest clinical importance because of its close implications with concomitant pathology. The adequate diagnosis of this rare anomaly is significant since the operative complications may occur in cases with DCBD which is not recognized prior to surgical treatment. 相似文献
16.
Cholangioscopy not only enables the direct visualization of the biliary tree, but also allows for forceps biopsy to diagnosis early cholangiocarcinoma. Recently, some reports have suggested the clinical usefulness of direct peroral cholangioscopy (POC) using an ultra-slim endoscope with a standard endoscopic unit by a single operator. Enhanced endoscopy, such as narrow band imaging (NBI), can be helpful for detecting early neoplasia in the gastrointestinal tract and is easily applicable during direct POC. A 63-year-old woman with acute cholangitis had persistent bile duct dilation on the left hepatic duct after common bile duct stone removal and clinical improvement. We performed direct POC with NBI using an ultra-slim upper endoscope to examine the strictured segment. NBI examination showed an irregular surface and polypoid structure with tumor vessels. Target biopsy under direct endoscopic visualization was performed, and adenocarcinoma was documented. The patient underwent an extended left hepatectomy, and the resected specimen showed early bile duct cancer confined to the ductal mucosa. 相似文献
17.
Horaguchi J Fujita N Noda Y Kobayashi G Ito K Takasawa O Obana T Endo T Nakahara K Honda H 《Journal of gastroenterology》2007,42(4):318-324
A 74-year-old woman, who had suffered from acute cholangitis, was referred to our department for further evaluation of the
biliary tree. A diagnosis of choledochocele was made by endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography.
A small flat elevation with cholesterolosis was observed in the lower bile duct, and circumferential wall thickening was apparent
in some parts of the upper and middle bile duct by intraductal ultrasonography and peroral cholangioscopy. With the diagnosis
of choledochocele associated with superficial spreading cancer and cholesterolosis of the bile duct, pylorus-preserving pancreaticoduodenectomy
was carried out. Microscopically, the tumor had spread extensively from the lower to the upper bile duct. Its invasion was
limited to the mucosa for the most part, with microinvasion of the subserosa in the upper bile duct. In the lower bile duct,
foamy cells were located beneath the neoplastic epithelium of the elevation. The number of cases of choledochocele associated
with biliary cancer is becoming higher than previously reported. This anomaly may play some role in the development of biliary
malignancy. Histological examination seems to be mandatory before making a diagnosis of cholesterolosis of the bile duct,
since this condition may occasionally accompany cancer. 相似文献
18.
Shinji Takai Yoshimune Shiratori Masayuki Kanematsu Kenji Yamazaki Takafumi Naiki Ichiro Yasuda Masahito Nagaki Nobuo Murakami Tomohiro Kato Hiroshi Takao Kuniyasu Shimokawa Hiroaki Hoshi Shigetoyo Saji Hisataka Moriwaki 《Journal of gastroenterology》2001,36(11):787-789
Received: February 21, 2000 / Accepted: November 10, 2000 相似文献
19.
Akiko Ogawa Hiroyuki Sugo Shigeru Takamori Kuniaki Kojima Masaki Fukasawa Tomoe Beppu Shunji Futagawa Hiroaki Fujii 《Journal of hepato-biliary-pancreatic sciences》2001,8(4):374-378
We report a 69‐year‐old man with double cancers in the common bile duct. One cancer was located between the superior and middle parts of the bile duct, while the other cancer was in the inferior part of the bile duct. Pylorus‐preserving pancreatoduodenectomy was performed. There was no communication between the two cancers in either the mucosal layer or the subepithelial layer. On pathological examination, the upper cancer was diagnosed as poorly differentiated adenocarcinoma, while the lower one was found to be moderately differentiated adenocarcinoma. We analyzed loss of heterozygosity (LOH), using microsatellite markers on five chromosomal arms, in both the upper and the lower cancers. Both cancers showed common regions of LOH at 5q, 6q, 9p, 17p, and 18q, whereas the upper cancer showed one additional region of LOH at 8p, thus suggesting progression, due to the acquisition of the additional LOH, in the upper cancer. No LOH was observed in the region between the two cancers. The presence of one additional LOH in the upper cancer suggests that the upper cancer was a metastasis of the lower one. 相似文献
20.
Hiroaki Yoshikane Senju Hashimoto Hitoshi Hidano Akira Sakakibara Tadao Ayakawa Sumito Mori Yoshihiro Kojima 《Journal of gastroenterology》1998,33(3):454-457
Emergency ultrasonography showed a protruding tumor in the markedly dilated common bile duct of a 33-year-old Japanese woman.
Magnetic resonance cholangiopancreatography also demonstrated the tumor clearly, almost as clearly as did percutaneous transhepatic
cholangiography. With a diagnosis of common bile duct carcinoma associated with congenital choledochal cyst, pancreaticoduodenectomy
was performed. In the resected specimen, as well as the protruding tumor, there was also a small slightly elevated lesion.
Pathology examination showed adenocarcinoma limited to the fibromuscular layer in the protruding tumor, and adenocarcinoma
limited to the mucosa in the elevated lesion. Prophylactic total excision of the choledochal cyst before the occurrence of
malignant change is strongly recommended in patients with congenital choledochal cyst. However, in those who are reluctant
to undergo the operation, periodic follow-up with ultrasonography and magnetic resonance cholangiopancreatography would be
ideal to achieve early detection of malignant change.
(Received May 9, 1997; accepted Sept. 26, 1997) 相似文献